The chemotherapy represses to the marrow of prevention and cure

Marrow's repressing is a chemotherapy the most familiar of main restriction the toxicity respond.Majority of chemotherapy medicines all can cause the marrow of having different degree's repressing, more familiar medicine such as:Mildewed vegetable, the Tai is plain, card platinum, different wreath Lin Mao An, long spring alkali etc..Because the grain cell exists time on the average the shortest, about is 6-8 hours, therefore the marrow represses to often first express to descend for white cell;The blood platelets exists time on the average about is 5-7 days, it descends to appear a little bit late lighter;But the red cell exist time as 120 days on the average, is influenced by chemotherapy smaller, descend usually not obvious.Majority of chemotherapy medicine to of the marrow repress and usually see 1-3 weeks after the chemotherapy and keep on around for 2-4 weeks to recover gradually, and with the white cell descend for lord, can have companion blood platelets to descend, minority of medicines,such as Jian, choose, card platinum, silk crack the mildewed plain classes and grades with the blood platelets descend for lord.
In order to monitor the occurrence that the marrow represses, chemotherapy period should periodically check blood normal regulations, the especially white cell counts, then should check once next day such as the obvious decrease 1-2 times every week, until the instauration is normal.Should adopt protection insulation in time for white cell descending the × 109/L the following sufferer up to 1, include to make the sufferer live alone a sickroom, in fixed time the ultraviolet ray disinfect, in fixed time well ventilated, having a condition can make use of an air cleaner and reduce visit number of times.Keep a sufferer the body form, bed Ru and dress trousers clean nattiness.Accompanying the family members should notice to replace clean dress, trousers, shoe, and wear to wear mouth-muffle, if existence breath way the infection then should avoid contacting the sufferer.
Under the normal circumstance, each kind of blood cell inside the body all from build the blood stem cell divides since then, its propagate, divide, distributing is adjusted to control by various cell factors with function to maintain the opposite stability of each kind of blood cell level.Build a blood stem cell to usually be placed in static appearance, be to build blood function damaged, building the blood stem cell can quickly divide, propagate but recover to build blood function.The mechanism that the chemotherapy makes the marrow repressed lies in:The chemotherapy medicine direct function in build blood stem cell and the marrow tiny environment, to its structure and the function harm.Cause marrow's repressing, its degree and keep on time it's related to measure strength with above-mentioned medicine category and, besides which, still with sufferer individual marrow storage the ability is near concern.For example, the liver disease suffers from, Pi function the Kang enters and since go toward have put to treat or many distance chemotherapy histories of sufferer, the marrow represses often more obvious.
Clinical up, build the blood cell gathers to fall to stimulate factor(CSFs) to pass a function in build a blood stem cell, start to promote to divide, propagate with mature, and increase its function.In common usely include G-CSF, GM-CSF, EPO and rhLI-11.The gene reorganizes a person grain the cell gathers to fall to stimulate factor(the G-CSF merchandise includes the blood of Hui Er, Ji grain the aroma and Rui wait in vain) and mainly pass to stimulate the marrow grain fastens Zu cell to gather to fall(CFU-G) to divide to propagate to the mature and neutral grain cell, and promotes mature and neutral grain of marrow cell outwardly the week blood release and activate the function of mature and neutral grain cell and prolong its life span etc. the mechanism increase outside week blood grain cell amount, its function presents amount of dependence, under the general circumstance the recommendation of G-CSF measure to 5 μ gskgd, use a medicine in a row 2-3 diva the white cell can immediately present up-trend.The gene reorganizes a person grain the cell is huge and bite cell and gather and fall and stimulate factor(the GM-CSF merchandise such as especially the Er grain wait) then the main function builds blood cell and divides at the marrow stage a little bit early, promote a grain of single fasten the Zu cell gathers and falls(CFU-GM) of propagate and divide, then the grain fasten, list check huge bite system cell and propagate, make outside week blood grain the cell and list check the amount increment of cell, and can be in conjunction with a function with the red cell born factor, promote the vitality of red cell, promote mature cell outwardly the week blood release, and have and raise the machine body anti- tumor and anti- and be infected the function of immunity dint.G-CSF and GM-CSF are used a medicine should after it's a little bit lowest to keep on to neutral grain cell to count under the doctor's instruction>10 × 109 Ls stop a medicine.To since go toward the chemotherapy once appeared a neutral grain of heavy degree behind the sufferer of cell decrease, can consider that the prevention is used a medicine.Should specially point out:G-CSF and GM-CSF generally start to be applied after 24~72 hours after the chemotherapy ends, but should not and chemotherapy and put to treat to apply in the meantime.About 15% it mainly badly responds for the bone pain, -40% sufferers accept 5 μ gskgd G-CSF treatment behind can appear a bone pain, measures an exaltation, the bone painful incidence rate is higher.Other familiar badly respond to include to have fever, have a headache, muscle ache etc., but majority of sufferers can bear to be subjected to.
Some the patent medicine thing,such as strong dint, in the cell rising blood living white slice of, the benefit blood living, rises white Anne and blood American Anne's capsule etc. has certain curative effect towards preventing white cell and blood platelets from descending also after taking orally.The heavy degree neutral grain cell descends to merge to have fever of sufferer, in order to often having merger advanced case the infection, septicemia of possibility, therefore at applied G-CSF and GM-CSF should consider the anti-virus vegetable treatment of giving in the meantime.
The chemotherapy makes the marrow repressed and the tumor makes progress, the kidney function injures, nourishment factor(iron, folic acid, and VIT-B12...etc.)'s lacking and being infected, losing a blood etc. factor all can cause tumor relativity anemic to take place.The application urges the red cell born vegetable(EPO merchandise such as benefit compare Ao etc.) to raise hemoglobin level and raise tumor the sufferer treat towards putting, the bearing of chemotherapy be subjected to and sensitivity, improvement tumor sufferer life quality.The EPO applied measures for the 150-300 IUsKg, every Wednesday time subcutaneous injection, as above say longer because of red cell life span, its treating a distance generally should reach to for 4-8 weeks.
Reorganize person's white to lie vegetable-11(such as huge with grain and Ji huge aroma etc.) for a kind of urge the blood platelets born factor, can directly stimulate to build blood of stem cell and huge pit Zu cell propagate and induce huge pit cell maturity to divide and increase the blood platelets in the body of born, raise the blood platelets amount in the outside week blood thus.Repress to the marrow to of blood platelets decrease the disease prevention and treatment measure for the 25 ugsKg, in chemotherapy be over empress 24-48 hour or discover blood platelets to reduce after the disease subcutaneous injection, treat a distance generally for 7-14 days once everyday, the blood platelets stops a medicine after counting the instauration.
Because the serious marrow represses to cause to be infected, bleed and heavy the degree is anemic, should consider the composition blood transfusion of giving when it's necessary.The losing of concentrated white cell notes:Everyday once, each time 16-20 units,(each 20 mls concentrated white cell is one unit, grain cell number ≥ 0.8 ×s 109 L) , lose to note in a row for 2-6 days or go to the infection control.Condense losing of blood platelets to note:Following day once, each time blood platelets one person or 8-16 units(each 30 ml concentrated blood platelets capacity is one unit, the blood platelets counts ≥ 2.4 × 1010 Ls), until the issue of blood is washed ups.